When it comes to placing family members into hospice care, experts say, it's critical for families to ask questions to help make more informed decisions.
"It's not the patient who's getting the hard sell," said Dawna White, a hospice nurse who writes allabouthospice.org, a blog. "It's the hospitals and the doctors."
Preparing for hospice -- or the possibility of needing hospice -- early can help because then people aren't forced to make quick decisions during a stressful time, she said.
"If a doctor recommends a specific hospice, ask why," White said.
There may be a legitimate reason -- such as joint research or good working relationships with health staff at the hospice -- or it may be there is a financial relationship between the physician and the hospice, she said.
She recommended finding out what services a hospice offers, and then talking to family members of patients who had gone through the program to make sure the hospice offered grief counseling and classes for family members after the patient had died.
White's website also gives advice about how Medicare benefits work when someone is in hospice. For example, patients may decide to leave hospice at any time, to receive curative care if they injure themselves, or if they simply decide not to continue in the program. Hospice may be reinstated at any time.
Karen Kehl, assistant professor at the school of nursing at the University of Wisconsin-Madison, said it's important that hospice staff answer questions, but also ask questions back about the patient.
"If they're not answering your questions, that would be of concern to me," she said.
Families should talk with several hospice organizations and not sign anything until they've had time to think about it, she said.
Organizations that offer good information include the National Hospice and Palliative Care Organization or the Hospice and Palliative Nurses Association.
Kehl also recommended talking to hospital or nursing facility nurses. "Physicians make the referrals," she said, "but nurses talk to the families after they make that decision."
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